Department Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Amsterdam UMC, University of Amsterdam, Department(s), Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands.
Int J Obes (Lond). 2022 Jul;46(7):1262-1270. doi: 10.1038/s41366-022-01107-1. Epub 2022 Mar 16.
Improving maternal lifestyle before conception may prevent the adverse effects of maternal obesity on their children's future cardiovascular disease (CVD) risk. In the current study, we examined whether a preconception lifestyle intervention in women with obesity could alter echocardiographic indices of cardiovascular health in their children.
Six years after a randomized controlled trial comparing the effects of a 6-month preconception lifestyle intervention in women with obesity and infertility prior to fertility care to prompt fertility care, 315 of the 341 children conceived within 24 months after randomization were eligible for this study. The intervention was aimed at weight loss (≥5% or until BMI < 29 kg/m). Children underwent echocardiographic assessment of cardiac structure and function, conducted by a single pediatric cardiologist, blinded to group allocation. Results were adjusted for multiple variables including body surface area, age, and sex in linear regression analyses.
Sixty children (32 girls, 53%) were included, mean age 6.5 years (SD 1.09). Twenty-four children (40%) were born to mothers in the intervention group. Children of mothers from the intervention group had a lower end-diastolic interventricular septum thickness (-0.88 Z-score, 95%CI -1.18 to -0.58), a lower left ventricle mass index (-8.56 g/m, 95%CI -13.09 to -4.03), and higher peak systolic and early diastolic annular velocity of the left ventricle (1.43 cm/s 95%CI 0.65 to 2.20 and 2.39 cm/s 95%CI 0.68 to 4.11, respectively) compared to children of mothers from the control group.
Children of women with obesity, who underwent a preconception lifestyle intervention, had improved cardiac structure and function; a thinner interventricular septum, lower left ventricle mass, and improved systolic and diastolic tissue Doppler velocities. Despite its high attrition rates, our study provides the first experimental human evidence suggesting that preconception lifestyle interventions may present a method of reducing CVD risk in the next generation.
LIFEstyle study: Netherlands Trial Register: NTR1530 ( https://www.trialregister.nl/trial/1461 ). This follow-up study was approved by the medical ethics committee of the University Medical Centre Groningen (METC code: 2008/284).
改善受孕前的孕产妇生活方式可能预防母体肥胖对其子女未来心血管疾病（CVD）风险的不利影响。在本研究中，我们检测了对肥胖女性进行受孕前生活方式干预是否能改变其子女的心血管健康的超声心动图指数。
在一项随机对照试验中，比较了在生育前进行 6 个月的受孕前生活方式干预对肥胖和不孕女性的影响，以促进生育护理，与直接进行生育护理相比，6 年后，341 名随机分配的儿童中有 315 名在 24 个月内受孕，符合本研究条件。干预的目的是减轻体重（≥5%或体重指数<29kg/m2）。由一名儿科心脏病专家对心脏结构和功能进行超声心动图评估，评估者对分组分配情况不知情。结果通过线性回归分析进行了多次变量调整，包括体表面积、年龄和性别。
纳入 60 名儿童（32 名女孩，53%），平均年龄 6.5 岁（SD 1.09）。24 名儿童（40%）为干预组母亲所生。与对照组母亲的子女相比，干预组母亲的子女的左心室舒张末期室间隔厚度较低（-0.88 Z 评分，95%CI-1.18 至-0.58），左心室质量指数较低（-8.56g/m，95%CI-13.09 至-4.03），左心室收缩期和早期舒张期瓣环速度较高（1.43cm/s，95%CI 0.65 至 2.20 和 2.39cm/s，95%CI 0.68 至 4.11）。
接受受孕前生活方式干预的肥胖女性的子女心脏结构和功能得到改善，室间隔更薄，左心室质量更低，收缩和舒张组织多普勒速度提高。尽管本研究的脱落率很高，但它首次提供了实验性人体证据，表明受孕前的生活方式干预可能是降低下一代 CVD 风险的一种方法。
LIFE 研究：荷兰试验注册中心：NTR1530（https://www.trialregister.nl/trial/1461）。这项随访研究得到了格罗宁根大学医学中心医学伦理委员会的批准（METC 代码：2008/284）。
